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Better nutrition trajectory improves recovery following a hip fracture surgery for older persons with diabetes mellitus

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Abstract

Background

Influences of nutritional status on hip fractured persons with diabetes mellitus (DM) following surgery have not been reported.

Aims

To explore the trajectory groups of nutritional status and their influences on post-operative recovery for older persons with hip fracture and DM.

Methods

A total of 169 patients with DM and hip fracture from a clinical trial were included in this analysis. Mini Nutritional Assessment was used to assess the nutritional status of the participants. Outcome variables included self-care ability, muscle strength, depressive symptoms, health related quality of life, and cognitive function, which were collected before discharge and 1-, 3-, 6-, 12-, 18-, and 24-months following hospital discharge.

Results

Among hip fractured older persons with DM, within two years following surgery there were three nutritional trajectory groups: malnourished (28.3%), at-risk of malnutrition (41.9%) and well-nourished (29.8%). A decline in nutritional status, especially for the malnourished group, was seen in the second year. A better nutritional trajectory was associated with better recovery outcomes, including self-care ability, health related quality of life, cognitive function and less depressive symptoms.

Discussion

Close to 30% of hip fractured persons with DM were considered to have a malnourished trajectory over 2 years following surgery. A poor nutritional trajectory was associated with poor mental health and physical recovery.

Conclusions

Continuous nutrition assessment during the first 2 years following hip fracture surgery for older persons with DM is important. Development and implementation of interventions targeting the malnourished trajectory group are suggested.

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Acknowledgements

This work was supported by the National Health Research Institutes, Taiwan (NHRI-EX103-9905PI); Chang Gung Medical Foundation (BMRP297) and the Healthy Aging Research Center, Chang Gung University from the Featured Areas Research Center Program within the Framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan (EMRPD1K0401). The funding agencies had no role in study design, collection, analysis and interpretation of data, in writing of the article, and in the decision to submit it for publication.

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Authors and Affiliations

  1. Post-Baccalaureate Program in Nursing, College of Nursing, Asia University, Taichung, Taiwan

    Ming-Yueh Tseng

  2. Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA

    Jersey Liang

  3. Department of Orthopedic Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Chi-Chuan Wu

  4. Department of Internal Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Huey-Shinn Cheng

  5. School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Ching-Tzu Yang

  6. Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan

    Ching-Yen Chen

  7. School of Nursing and Healthy Aging Research Center, Chang Gung University, 259 Wenhua 1st Road, Guishan District, 33302, Taoyuan, Taiwan

    Yea-Ing L. Shyu

  8. Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan, Taiwan

    Yea-Ing L. Shyu

  9. Dementia Center, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Yea-Ing L. Shyu

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Contributions

M.-Y. T.: Conceptualization, Methodology, Formal analysis, Writing—Original draft, Visualization. J. L.: Conceptualization, Methodology, Formal analysis, Writing—Original draft, Visualization. C.-C. W., H.-S. C., C.-Y. C.: Investigation, Resources, Visualization. C.-T. Y.: Investigation, Data curation, Project administration. Y.‐I. L. S.: Conceptualization, Methodology, Writing—Original draft, Visualization, Supervision, Funding acquisition.

Corresponding author

Correspondence to Yea-Ing L. Shyu.

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Tseng, MY., Liang, J., Wu, CC. et al. Better nutrition trajectory improves recovery following a hip fracture surgery for older persons with diabetes mellitus. Aging Clin Exp Res 34, 2815–2824 (2022). https://doi.org/10.1007/s40520-022-02221-w

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